4. Prion diseases  What is a prion?  How do prions cause disease?  Name 3 prion diseases  How would you prevent the risk of prion
diseases in ophthalmology?  A case scenario of a young keratoconic
patient awaiting corneal grafting and he is concerned about this risk.
How would you counsel him?

5. Vasculitis  What is the clinicopathological classification?  Wegeners and role of ANCA  Describe histological slide  Complications of Wegeners

7. Endophthalmitis  Patient presents 2 days following
phaco with endophthalmitis  Name 2 most likely organisms  Name most important procedure for diagnosis  What 4 culture media would you request
for culture?  2 advantages of vitrectomy  Another patient has a penetrating trauma
related endophthalmitis. Name 4 likely Gram -ve organisms.

8. MRSA  Describe the picture: Agar plate showing
colonies. 4 circular pieces of paper impregnated with antibiotics,
only sensitive to vancomycin.  What is the organism?  Management of MRSA patient on the ward

9. Acanthamoeba  Name 2 routine stains used (not calcofluor
white)  In what forms do acanthamoeba exist?  Name 2 treatment used  What culture medium would you use for
fungal keratitis?

10. Conjuntival slides  Rather odd looking, supposedly according
to the caption there is elastotic degeneration  3 possible causes for this picture  How would you differentiate them clinically
and histologically?

14. Optic neuritis  Visual prognosis in optic neuritis  What is the risk of MS?  What are the histopathological features
of MS?

15. Giant papillary conjunctivitis

CRQs MRCOphth Part 3:
Southampton,September 2005

1. Picture of macroscopic and microscopic
histology of a pilomatrixoma stem  Patient presented with a lesion
diagnosed as a pilomatrixoma Q1. Give 4 histological features
seen Q2. Which 2 places are these commonly
found? Q3. There are 2 syndromes in which
these are found. Name one.

2. Picture of a corneal section. 20 yr
old patient with worsening vision despite refraction. Q1. What are the 3 histological features
seen in the slide? ( Descemets break at the edge, but not much else seen
except for artefactual stromal splitting) Q2. What is the diagnosis? Q3. What would you call it if there is
a sudden break in the Descemet's in this condition? 3. Picture of a colour Doppler with an
arrow at a stenosis. A 74 yr old presented with visual loss of less than
24 hours. Q1. What is the name for this symptom? Q2. What investigation is this? Q3. What is the pathophysiology of this
symptom? Q4. What treatment would you recommend? Q5. What evidence is there for this treatment? 4. Picture of exenterated orbit with large
ulcer at the lateral canthus with 2 histological slides of BCC). A ~50
year old was operated on for a large ulcer at his lateral canthus. Q1. What is the type of lesion? Q2. What does this lesion cause around
it within the dermal structures? Q3. How would you excise this lesion if
it wasnt clinically obvious? 5. Picture of a (choroidal melanoma) invading
through posterior sclera in a mushroom shape. A patient previously treated
for ocular melanoma presented with pain and reduced vision. Q1. What are the histological features
seen? Q2. Give 4 modalities of treatment for
this condition. Q3. What 2 investigations would you perform
on this patient? 6. Microscopic histological picture of
normal retina. Mark on the picture the layer in which each of these conditions
present. Q1. Neovacularization in diabetes Q2. Microcystoid degeneration. Q3. Coats disease  where is the macrophage
with ingested pigment Q4. Drusen Q5. Central retinal artery occlusion 7. Histological picture of a (ragged red
muscle fibre). This patient presents with peripheral pigmentary retinopathy
and ophthalmolplegia and had a muscle biopsy. Q1. What is the diagnosis? Q2. Which muscle would you biopsy? Q3. How would you transport this specimen
to the lab? Q4. What is the diagnostic appearance
of the biopsy for this condition? 8. Picture of lymphocytes in a vitreous
tap. Patient presented with hazy vision with vitritis. CD 20+ cells found
in this vitreous tap. Q1. What is the diagnosis? Q2. What is the prognosis? Q3. What is the treatment? Q4. What are the other simple investigations
you would perform? 9. Picture of a corneal section (with
?vessels). Patient who had a graft presented with worsening vision
and an endothelial line. Not a recurrence of the primary cause for a graft. Q1. What is the diagnosis? Q2. What are the 4 causes of graft rejection Q3. Which cells mediate rejection? Q4. What are the histological features
seen? 10. Picture of a ?dermoid cyst. This patient
presents from birth but patient presented late due to failure to keeping
appointment. Q1. What is the diagnosis? Q2. Where is the commenest site for this
lesion? 11. Muscle histopathology slide. Muscle
biopsy of a patient with proptosis Q1. Describe the histopathological features Q2. Which cells mediate this? Q3. What is the diagnosis Q4. Does treating the thyroid condition
alter the TED? Q5. What blood investigations would you
perform?

2. Photomicrographs of Exenteration
specimen shown.  MC malignant orbital tumor in adults MC orbital tumour in children What do you see in cross section What do you see in the histological
section( Sebaceous cell ca) 3 other malignat orbital tumours